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Peoria woman initiates uniform wristband system

Barb Averyt of Peoria recently spearheaded the effort to have uniform color wristbands for hospital patients, alerting health care workers to DNR, allergies and fall risk.(Mollie J. Hoppes/Daily News-Sun)
A Peoria woman is being recognized for spearheading an initiative that helps alert Arizona hospital workers of at-risk patients. And the program is expanding nationwide.

Sun Health Boswell and Del E. Webb Hospitals have been using the uniform color-coded wristbands since the program was introduced in the spring.

“It’s important for Sun Health to be enhancing what we are doing,” said chief nursing officer Deb Finch. “We were an early partner to show our commitment to patient safety.”

Barb Averyt, program director of patient safety at Arizona Hospital and Healthcare Association, started Safe & Sound. The patient initiative is the first in the nation that has brought the state’s hospitals together to adopt a uniform color-coded wristband system to identify patients who have Do Not Resuscitate (DNR) orders, allergies, or who are a fall risk.

She received an award recognizing her efforts in leadership in patient safety through the Arizona Partners for Implementing Patient Safety.

Averyt said that a large portion of nurses and doctors practice at more than one hospital. But the colored wristbands that are used to identify Do Not Resuscitate (DNR), allergy and fall risk varied from hospital to hospital. That could confuse medical staff.

Averyt said that an incident at a Pennsylvania hospital, where a nurse gave the patient the wrong color medical-alert wristband which could have caused a fatality, sparked her to research how Arizona hospitals were using color to designate at-risk and DNR patients.

At that time, eight different colored wristbands were being used in the 47 Arizona hospitals to signify DNR.

Averyt said that she pulled together a work team that included representatives from hospitals across the state to discuss how to resolve the issue.

“We determined that we were going to concentrate on uniform colors for three different alert responses: DNR, allergy and fall risk.

“DNR was an immediate need to be addressed, allergy was important because if you give a medication that they are allergic to there are serious consequences or even death.”
“And fall risk (was needed) because falls are a costly issue in health care that we need to be aware and prevent,” Averyt said.

Averyt’s group found that there were no other countries that had a standardized color-coded wristband policy.

“We dreamed a little, and thought, ‘What if we could standardize it and others could adopt the same standard?’” Averyt said. “That was our big dream.”

The group then needed to decide which colors to use for each alert.

“We did a lot of color association research,” Averyt said.

Red was used to designate allergy risk because the group’s surveys found that three-quarters of the hospitals were already using it.

“And red has a ‘stop’ connotation,” Averyt said. “Stop and look if there is an allergy before giving a medication.”

Fall risk was designated as yellow.

“Yellow has a slow down connotation, caution — barricade lights are yellow and flashing,” Averyt said. “It was the proper mental association.”

The DNR color inspired some lively conversation, she said.

“We knew green would be out, because green means go forward and that was not the message we should have,” Averyt said. “DNR is an end of life wish not to take extreme measures to bring them back and we need to honor that as a patient’s last wish.”

Blue was considered and rejected, because in a hospital setting a “code blue” would send a conflicting message since that normally inspired a response to revive a patient.

Pink was rejected since it was associated with breast cancer and also used in some hospitals to indicate lymphodema.

“We decided to use purple instead, it almost presented itself,” Averyt said.

The program was launched in late April and has been adopted statewide.

“We’re pedaling it to neighboring states and so far Oregon, California, Colorado, New Mexico, Missouri and West Virginia have adopted it,” Averyt said. “And in the queue looking at how to proceed are Nevada, Utah, New York and New Jersey.”

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